A basic screening test that evaluates the cells

“A basic screening test that evaluates the cells that circulate in blood. ” A complete blood count (CBC), also known as full blood count (FBC) or full blood exam (FBE) or blood panel.

Screen for a wide range of conditions and diseases Monitor the condition and/or effectiveness of treatment after a diagnosis is established Help diagnose various conditions, such as anemia , infection, inflammation, bleeding disorder or leukemia etc Monitor treatment that is known to affect blood cells, such as chemotherapy or radiation therapy

• A CBC is a panel of tests that evaluates the three types of cells that circulate in the blood and includes the following: ü Evaluation of white blood cells ü Evaluation of red blood cells ü Evaluation of platelets

• White blood cell (WBC) count is a count of the total number of white blood cells in a person's sample of blood. All the white cell types are given as a percentage and as an absolute number per litre. • White blood cell differential may or may not be included as part of the panel of tests. It identifies and counts the number of the various types of white blood cells present. The five types include neutrophils, lymphocytes, monocytes, e osinophils, and basophils.

WBC: 4, 000 – 10, 000/cubicmm WBC DIFFERENTIAL: Neutrophil 40 -75% Lymphocytes 15 -75% Monocytes 1 -10% Eosinophils 1 -6% Basophils 0 -2%

Test WBC Full Name examples of causes of a low count examples of causes of a high count White Blood Cell Count Known as leukopenia or damage Known as leukocytosis • Autoimmune conditions • Severe infections (sepsis) • lymphoma or other cancer that spread to the bone marrow • Diseases of immune system (e. g. , HIV) • infections most commonly bacterial or viral • Leukemia, myeloproliferative disorders • inflammation • Allergies , Asthma • Tissue death (trauma, burns, heart attack) • Intense exercise or severe stress

Test Full Neu, PMN, polys Name examples of causes of a low count examples of causes of a high count Absolute neutrophil count, % neutrophils Known as neutropenia • Severe, over whelming infection (sepsis) • Autoimmune disorders • Reaction to drugs, chemotherapy • Immunodeficiency • Bone marrow damage (e. g. , chemotherapy, radiation therapy) Known as neutrophilia • Acute bacterial infections • Inflammation • Tissue death (necrosis) caused by trauma, heart attack, burns • leukemia eos Absolute eosinophil count, % eosinophils not medically significant. Parasitic infections, asthma, allergic reaction. baso Absolute basophil count, not medically significant % basophils bone marrow related conditions such as leukemia or lymphoma

TEST Full mono lympho Name examples of causes of a low count examples of causes of a high count Absolute monocyte count, % monocytes not medically significant. bacterial infection, tuberculosis, malaria, monocytic leukemia Absolute Lymphocyte count, % lymphocytes Known as lymphocytopenia • Autoimmune disorders (e. g. , lupus rheumatoid arthritis) • Infections (e. g. , HIV, viral hepatitis , typhoid fever, influenza) • Bone marrow damage (e. g. , chemotherapy, radiation therapy) • Corticosteroids Known as lymphocytosis • Acute viral infections (e. g. , chicken pox, cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes) • Certain bacterial infections (e. g. tuberculosis • Lymphocytic leukemia, lymphoma • Stress (acute)

ü Red blood cell (RBC) count is a count of the actual number of red blood cells in a person's sample of blood. ü Hemoglobin measures the amount of the oxygen-carrying protein in the blood. ü Hematocrit measures the percentage of a person's blood that consists of red blood cells. ü Red blood cell indices are calculations that provide information on the physical characteristics of the RBCs: • (RDW), which may be included in a CBC, is a calculation of the variation in the size of RBCs. • Mean corpuscular volume (MCV) is a measurement of the average size of RBCs. • Mean corpuscular hemoglobin is a calculation of the average amount of oxygen-carrying hemoglobin inside a red blood cell. • Mean corpuscular hemoglobin concentration (MCHC) is a calculation of the average percentage of hemoglobin inside a red cell. ü reticulocyte count which is a measurement of the absolute count or percentage of young red blood cells in blood.

Test Full Name examples of causes of low result examples of causes of high result RBC Red Blood Cell Count Known as anemia • Acute or chronic bleeding • RBC destruction (e. g. hemolytic anemia, etc. ) • Nutritional deficiency (e. g. , iron deficiency, vitamin B 12 or folate deficiency) • Bone marrow disorders or damage • Chronic inflammatory disease • Kidney failure Known as polycythemia • Dehydration • Pulmonary disease • Kidney or other tumor that produces excess erythropoietin • Smoking • Genetic causes (altered oxygen sensing, abnormality in hemoglobin oxygen release) Hb Hemoglobin Usually mirrors RBC results, provides added information Usually mirrors RBC results Hct Hematocrit Usually mirrors RBC results; most common cause is dehydration

Test Full Name examples of causes of low result examples of causes of high result MCV Mean Corpuscular Volume Indicates RBCs are smaller than normal (microcytic); caused by iron deficiency anemia or thalassemia, for example. MCH Mean Corpuscular Hemoglobin Mirrors MCV results; macrocytic Mirrors MCV results; small red cells RBCs are large so tend to have a would have a lower value. higher MCHC Mean Corpuscular Hemoglobin Concentration May be low when MCV is low; decreased MCHC values (hypochromia) are seen in conditions such as iron deficiency anemia and thalassemia. Indicates RBCs are larger than normal (macrocytic), for example in anemia caused by folate or vit B 12 deficiency Increased MCHC values (hyperchromia) are seen in conditions where the hemoglobin is more concentrated inside the red cells, such as autoimmune hemolytic anemia, in burn patients, and hereditary spherocytosis, a rare congenital disorder.

Test Full Name Examples of causes of low result Examples of causes of high result RDW RBC Low value indicates uniformity in Distributio size of RBCs n Width Indicates mixed population of small and large RBCs; immature RBCs tend to be larger. For example, in iron deficiency anemia or pernicious anemia, there is high variation (anisocytosis) in RBC size (along with variation in shape – poikilocytosis), causing an increase in the RDW. Reticulocyte count In the setting of anemia, a low Reticulocy reticulocyte count indicates a tes condition is affecting the production (absolute of red blood cells, such as bone count or marrow disorder or damage, or a %) nutritional deficiency (iron, B 12 or folate) In the setting of anemia, a high reticulocyte count generally indicates peripheral cause, such as bleeding or hemolysis, or response to treatment (e. g. , iron supplementation for iron deficiency anemia)

The platelet count is the number of platelets in a person's sample of blood. Mean platelet volume (MPV) may be reported with a CBC. It is a calculation of the average size of platelets. Platelet distribution width (PDW) may also be reported with a CBC. It is a measurement of the variation of platelet size.

• Platelet count : 140, 000 to 450, 000 /cubic mm • Mean platelet volume: 7. 5 – 11. 5 f. L • Platelet distribution width: 10% - 17. 9%

Test Full Name examples of causes of low result examples of causes of high result plt Platelet Count Known as thrombocytopenia: • Viral infection (mononucleosis, hepatitis) • Rocky mountain spotted fever • Platelet autoantibody • Drugs (acetaminophen, quinidine, sulfa drugs) • cirrhosis • Autoimmune disorders • Sepsis • Leukemia, lymphoma • Myelodysplasia • Chemo or radiation therapy Know as thrombocytosis: • Cancer (lung, gastrointestinal, lymphoma) • Rheumatoid arthritis, inflammatory bowel disease, lupus • Iron deficiency anemia • Hemolytic anemia • Myeloproliferative disorder (e. g. , essential thrombocythemia)

Test MPV PDW Full Name Examples of causes of low result Examples of causes of high result Mean Platelet Volume Indicates average size of platelets is small; older platelets are generally smaller than younger ones and a low MPV may mean that a condition is affecting the production of platelets by the bone marrow. Indicates a high number of larger, younger platelets in the blood; this may be due to the bone marrow producing and releasing platelets rapidly into circulation. Platelet Distribution Width Indicates uniformity in size of platelets Indicates increased variation in the size of the platelets, which may mean that a condition is present that is affecting platelets

Reviewing clinical laboratory test results about a patient's condition can provide valuable information for ü Diagnosis and management of orofacial conditions ü Guidance on assessing the patient's ability to tolerate the proposed dental treatment ü A prognosis based on a particular treatment

EVALUATION OF WBC • when a patient is being treated with a medication that suppresses WBC production (such as antineoplastic agents), the patient is at a greater risk for postoperative infection, and dental treatment should be deferred until the WBC result is back to normal. • For invasive dental treatment, perioperative antibiotics are indicated in patients with ANC less than 1, 000 cells/mm 3 in order to minimize the risk of infection. When the ANC falls below 500 cells/mm 3, intravenous antimicrobial therapy may be necessary to prevent sepsis resulting from invasive dental treatment.

EVALUATION OF RBC • Patients with polycythemia may experience orthopnea in the dental chair, dizziness, headache, red facial coloring, and dyspnea. • Hgb and Hct are necessary parts of the assessment for anemias and in patients with burning mouth disorders and aphthous stomatitis. • Differ routine dental treatment in Patient with severe anemia

EVALUATION OF PLATELETS • Bleeding disorders or bone marrow diseases, such healthcare provider to determine as leukemia, require the dental the number of platelets present and/or their ability to function correctly prior to invasive surgery. • Minor dentistry: counts should be greater than 50, 000/cubicmm